COVID-19 in the Eastern Brazilian Amazon: Incidence, Clinical Management, and Mortality by Social Determinants of Health, Symptomatology, and Comorbidities in the Xingu Health Region

Eric Renato Lima Figueiredo, Márcio Vinicius de Gouveia Affonso, Rodrigo Januario Jacomel, Fabiana de Campos Gomes, Nelson Veiga Gonçalves, Claudia do Socorro Carvalho Miranda, Márcia Cristina Freitas da Silva, Ademir Ferreira da Silva-Júnior and João Simão de Melo-Neto ()
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Eric Renato Lima Figueiredo: Institute of Health Sciences, Federal University of Pará (UFPA), Belem 66075-110, Brazil
Márcio Vinicius de Gouveia Affonso: Institute of Health Sciences, Federal University of Pará (UFPA), Belem 66075-110, Brazil
Rodrigo Januario Jacomel: Institute of Health Sciences, Federal University of Pará (UFPA), Belem 66075-110, Brazil
Fabiana de Campos Gomes: Faculty of Medicine of São José do Rio Preto (FAMERP), São José do Rio Preto 15090-000, Brazil
Nelson Veiga Gonçalves: Laboratory of Epidemiology and Geoprocessing of Amazon, University of the state of Pará (UEPA), Belem 66050-540, Brazil
Claudia do Socorro Carvalho Miranda: Laboratory of Epidemiology and Geoprocessing of Amazon, University of the state of Pará (UEPA), Belem 66050-540, Brazil
Márcia Cristina Freitas da Silva: Faculty of Medicine, Federal University of Pará, Altamira 68370-000, Brazil
Ademir Ferreira da Silva-Júnior: Faculty of Medicine, Federal University of Pará, Altamira 68370-000, Brazil
João Simão de Melo-Neto: Institute of Health Sciences, Federal University of Pará (UFPA), Belem 66075-110, Brazil

IJERPH, 2023, vol. 20, issue 5, 1-20

Abstract: This study aims to investigate the relationship between social determinants of health (SDH), incidence, and mortality to verify which sociodemographic factors, symptoms, and comorbidities predict clinical management; second, this study aims to conduct a survival analysis of individuals with COVID-19 in the Xingu Health Region. Consequently, this study adopted an ecological framework, employing secondary data of COVID-19-positive individuals from the Xingu Health Region, Pará State, Brazil. The data were obtained through the database of the State of Pará Public Health Secretary (SESPA) for the period from March 2020 to March 2021. The incidence and mortality were higher in Vitória do Xingu and Altamira. Municipalities with a higher percentage of citizens with health insurance and higher public health expenditure showed a higher incidence and mortality. A higher gross domestic product was associated with a higher incidence. Females were found to be associated with better clinical management. To live in Altamira was a risk factor for intensive care unit admission. The symptoms and comorbidities that predicted worse clinical management were dyspnea, fever, emesis, chills, diabetes, cardiac and renal diseases, obesity, and neurological diseases. There were higher incidence, mortality, and lower survival rates among the elderly. Thus, it can be concluded that SDH indicators, symptomatology, and comorbidities have implications for the incidence, mortality, and clinical management of COVID-19 in the Xingu Health Region of eastern Amazonia, Brazil.

Keywords: COVID-19; incidence; social determinants of health; health services; health policy; pandemic (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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